1. Interoperability Roadmap Comments Package Implementation, Certification, and Testing (ICT) Workgroup February 13, 2015 Liz Johnson, co-chair Cris Ross, co-chair

2. Principle-based Interoperability 2 ONC Guiding Principles ONC Working to establish a floor, not a ceiling (allow room for innovation) Working to create a system that allows data to move around a person (not just at the encounter) Tried to be as parsimonious as possible for a learning health system that allow the kinds of research that we want This is Version 1.0, we will continue to iterate – just the beginning of the journey Hoping to identify opportunities to allow the private sector be at the forefront (e.g. Argonaut project). How can the federal government work in partnership?

3. Interoperability Roadmap Section I1 Testing Tools 3 Charge Question In what ways can semantic interoperability be tested? (e.g., CCDA content semantics) Questions for Workgroup Discussion Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? What, if any, gaps need to be addressed? Is the timing of specific actions appropriate? Are the right actors/stakeholders associated with critical actions? Category 2015-2017 Send, receive, find and use a common clinical data set 2018-2020 Expand interoperable health IT and users 2021-2024 Achieve nationwide LHS I1. Testing Tools Workgroup Member(s): 1.ONC, NIST and other health IT stakeholders will provide testing tools necessary to support the criteria in ONC's certification program. 2.Health IT developers, SDOs and government will explore and accelerate a suite of testing tools that can be used by implementers post- implementation to ensure continued interoperability while health IT is in use. 3.SDOs begin to develop and maintain additional testing tools in support of more stringent testing of standards 4.ONC, NIST and other health IT stakeholders will provide updated testing tools in support of ONC's certification program. 5.Health IT Developers, SDOs and government will maintain a suite a testing tools. 6.Health IT developers will regularly use testing tools to maintain interoperability while health IT is in use. 7.ONC, NIST and other health IT stakeholders will provide updated testing tools in support of ONC's certification program. 8.Health IT developers. SDOs and government will maintain a suite of testing tools.

4. 4 Charge QuestionComments In what ways can semantic interoperability be tested? (e.g., CCDA content semantics) Interoperability Roadmap Charge Question

5. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 5 2015-2017 Send, receive, find and use a common clinical data set Comments 1.ONC, NIST and other health IT stakeholders will provide testing tools necessary to support the criteria in ONC's certification program. 2.Health IT developers, SDOs and government will explore and accelerate a suite of testing tools that can be used by implementers post-implementation to ensure continued interoperability while health IT is in use.

6. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 6 2015-2017 Send, receive, find and use a common clinical data set Comments 3.SDOs begin to develop and maintain additional testing tools in support of more stringent testing of standards

7. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 7 2018-2020 Expand interoperable health IT and users Comments 4.ONC, NIST and other health IT stakeholders will provide updated testing tools in support of ONC's certification program. 5.Health IT Developers, SDOs and government will maintain a suite a testing tools.

8. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 8 2018-2020 Expand interoperable health IT and users Comments 6.Health IT developers will regularly use testing tools to maintain interoperability while health IT is in use.

9. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 9 2021-2024 Achieve nationwide LHS Comments 7.ONC, NIST and other health IT stakeholders will provide updated testing tools in support of ONC's certification program. 8.Health IT developers, SDOs and government will explore and accelerate a suite of testing tools that can be used by implementers post-implementation to ensure continued interoperability while health IT is in use.

10. Interoperability Roadmap Section I2 Certification Programs 10 Questions for Workgroup Discussion Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? What, if any, gaps need to be addressed? Is the timing of specific actions appropriate? Are the right actors/stakeholders associated with critical actions? Category 2015-2017 Send, receive, find and use a common clinical data set 2018-2020 Expand interoperable health IT and users 2021-2024 Achieve nationwide LHS I2. Certification Programs Workgroup Member(s): 1.Health IT Developers, ACBs, ATLs and other stakeholders will analyze, identify gaps and provide feedback to ONC regarding certification criteria that should be added to the ONC HIT Certification Program. Specifically, criteria that would support ONC’s desire to expand the scope of the certification program to support health IT used in a broader set of health care settings, such as criteria for long-term and post-acute care, home and community based services in non- institutional settings and behavioral health settings. Additionally, criteria related to accessibility and usability of health IT. 2.Other existing industry certification programs will continue to complement ONC's certification program to ensure that different aspects of health IT conform to the technical standards necessary for interoperability. 3.FACAs will make recommendations for standards and certification criteria for inclusion in ONC’s certification program. 4.Health IT developers, ACBs, ATLs and other stakeholders will continue to provide feedback to ONC regarding certification criteria that could be added to the ONC HIT Certification Program in order to increase its impact on interoperability 5.ONC and other industry certification programs will focus on including more stringent testing such as scenario-based testing and post-implementation testing to ensure interoperability while health IT is in use. 6.ONC and other industry certification programs will continue to update criteria as needed in support of a learning health system's evolving needs, new standards and expanded program's scope to include health IT used in a broader set of health care settings.

11. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 11 2015-2017 Send, receive, find and use a common clinical data set Comments 1.Health IT Developers, ACBs, ATLs and other stakeholders will analyze, identify gaps and provide feedback to ONC regarding certification criteria that should be added to the ONC HIT Certification Program. Specifically, criteria that would support ONC’s desire to expand the scope of the certification program to support health IT used in a broader set of health care settings, such as criteria for long-term and post-acute care, home and community based services in non- institutional settings and behavioral health settings. Additionally, criteria related to accessibility and usability of health IT.

12. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 12 2015-2017 Send, receive, find and use a common clinical data set Comments 2.Other existing industry certification programs will continue to complement ONC's certification program to ensure that different aspects of health IT conform to the technical standards necessary for interoperability. 3.FACAs will make recommendations for standards and certification criteria for inclusion in ONC’s certification program.

13. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 13 2018-2020 Expand interoperable health IT and users Comments 4.Health IT developers, ACBs, ATLs and other stakeholders will continue to provide feedback to ONC regarding certification criteria that could be added to the ONC HIT Certification Program in order to increase its impact on interoperability 5.ONC and other industry certification programs will focus on including more stringent testing such as scenario-based testing and post-implementation testing to ensure interoperability while health IT is in use.

14. 1. Are the actions the right actions to improve interoperability nationwide in the near term while working toward a learning health system in the long term? 2. What, if any, gaps need to be addressed? 3. Is the timing of specific actions appropriate? 4. Are the right actors/stakeholders associated with critical actions? 14 2021-2024 Achieve nationwide LHS Comments 6.ONC and other industry certification programs will continue to update criteria as needed in support of a learning health system's evolving needs, new standards and expanded program's scope to include health IT used in a broader set of health care settings.